Zhang Jiaqi, Bai Wenliang, Guo Chao, Liu Lei, Wang Guige, Huang Cheng, Chen Yeye, Zhang Ye, Li Shanqing
Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, People's Republic of China.
Cancer Manag Res. 2020 Oct 1;12:9485-9493. doi: 10.2147/CMAR.S266376. eCollection 2020.
To investigate postoperative temporary consequences of the enrolled patients with lung adenocarcinoma.
We analyzed the clinical data of patients with lung adenocarcinoma admitted by the same surgical team of Peking Union Medical College Hospital (PUMCH) from July 2019 to December 2019. Statistical methods including propensity score matching (PSM) analysis was used to analyze the differences among them.
A total of 108 patients were enrolled, including 50 patients with sublobar resection and 58 patients with lobectomy. Before PSM, there were statistically significant differences in age (=0.015), hospitalization costs (=0.042), lymphadenectomy (=0.000), pathological staging (=0.000), number of lymph nodes removed (=0.000), number of positive lymph nodes (=0.034), chest drainage duration (=0.000), total chest drainage (=0.000), length of postoperative hospital stays (=0.000), postoperative D-dimer level (=0.030) and perioperative lymphocyte margin (LM) (=0.003) between sublobar resection and lobectomy. After PSM, there were statistical differences in number of lymph nodes removed (=0.000), chest drainage duration (=0.031) and total chest drainage (=0.002) between sublobar resection and lobectomy. Whether with PSM analysis or not, there were no significant differences in other blood test results, such as inflammation indicators, postoperative neutrophil-lymphocyte ratio (NLR), albumin level, perioperative activity of daily living (ADL) scale scoring margin, complications, postoperative admission to intensive care unit (ICU) and readmission within 30 days. NLR was associated with total chest drainage (=0.000), length of postoperative hospital stays (=0.000), postoperative D-dimer level (=0.050) and ADL scale scoring margin (=0.003) between sublobar resection and lobectomy.
Sublobar resection, including wedge resection and segmentectomy, was as safe and feasible as lobectomy in our study, and they shared similar short-term outcomes. Postoperative NLR could be used to detect the clinical outcomes of patients. Secondary resectability of pulmonary function (SRPF) should be the main purpose of sublobar resection.
研究纳入的肺腺癌患者术后的短期后果。
我们分析了2019年7月至2019年12月期间北京协和医院同一手术团队收治的肺腺癌患者的临床资料。采用包括倾向评分匹配（PSM）分析在内的统计方法分析他们之间的差异。
共纳入108例患者，其中肺叶下切除患者50例，肺叶切除患者58例。在PSM之前，肺叶下切除和肺叶切除在年龄（=0.015）、住院费用（=0.042）、淋巴结清扫（=0.000）、病理分期（=0.000）、切除淋巴结数量（=0.000）、阳性淋巴结数量（=0.034）、胸腔引流持续时间（=0.000）、胸腔总引流量（=0.000）、术后住院时间（=0.000）、术后D - 二聚体水平（=0.030）和围手术期淋巴细胞边缘（LM）（=0.003）方面存在统计学显著差异。PSM之后，肺叶下切除和肺叶切除在切除淋巴结数量（=0.000）、胸腔引流持续时间（=0.031）和胸腔总引流量（=0.002）方面存在统计学差异。无论是否进行PSM分析，其他血液检测结果，如炎症指标、术后中性粒细胞与淋巴细胞比值（NLR）、白蛋白水平、围手术期日常生活活动（ADL）量表评分差值、并发症、术后入住重症监护病房（ICU）以及30天内再次入院情况均无显著差异。在肺叶下切除和肺叶切除之间，NLR与胸腔总引流量（=0.000）、术后住院时间（=0.000）、术后D - 二聚体水平（=0.050）和ADL量表评分差值（=0.003）相关。
在我们的研究中，包括楔形切除和肺段切除在内的肺叶下切除与肺叶切除一样安全可行，且具有相似的短期结局。术后NLR可用于检测患者的临床结局。肺功能二级可切除性（SRPF）应是肺叶下切除的主要目的。
